The present invention relates to a surgical operating apparatus which performs therapeutic treatment, such as incision, resection or coagulation, of a living body tissue by making use of ultrasonic and composite energy of ultrasonic and high-frequency waves.
Jpn. Pat. Appln. KOKAI Publication No. 2006-223741 (Patent Document 1), for instance, discloses an ultrasonic therapeutic apparatus as a general example of an ultrasonic therapeutic apparatus which can perform therapeutic treatment, such as incision, resection or coagulation, of a living body tissue by making use of ultrasonic and can also perform therapeutic treatment by high-frequency waves.
In this apparatus, a proximal-side operation section is coupled to a proximal end portion of an elongated insertion section. An ultrasonic transducer which generates ultrasonic vibration is provided in the operation section. A therapeutic section for treating a living body tissue is provided at a distal end portion of the insertion section.
The insertion section has an elongated tubular sheath. A rod-shaped vibration transmission member (probe) is inserted in the sheath. A proximal end portion of the vibration transmission member is detachably attached to the ultrasonic transducer via a screw-type coupling section. Ultrasonic vibration, which is generated by the ultrasonic transducer, is transmitted to a probe distal end portion at the distal end side of the vibration transmission member.
In the therapeutic section, a jaw is disposed to be opposed to the probe distal end portion. A proximal end portion of the jaw is rotatably supported on a distal end portion of the sheath via a support shaft. An operation rod for driving the jaw is inserted in the sheath so as to be axially advancible/retreatable. The operation section is provided with an operation handle. In accordance with the operation of the operation handle, the operation rod is axially advanced/retreated. In interlock with the operation of the operation rod, the jaw is opened/closed relative the probe distal end portion.
At this time, a living body tissue is held between the probe distal end portion and the jaw in accordance with the closing operation of the jaw. In this state, ultrasonic vibration from the ultrasonic transducer is transmitted to the probe distal end portion on the therapeutic section side via the vibration transmission member. Thereby, using ultrasonic, therapeutic treatment, such as incision, resection or coagulation, of the living body tissue is performed.
In addition, in the apparatus of the above-described Patent Document 1, a proximal end portion of the sheath is detachably coupled to the operation handle of the operation section. Further, a high-frequency connection pin is attached to the operation section. An electric cord for supplying high-frequency current from a high-frequency cauterization power supply device is connected to the high-frequency connection pin. An inner end portion of the high-frequency connection pin is electrically connected to the probe distal end portion of the therapeutic section or to the jaw via an electric conduction path within the operation section and the sheath. High-frequency current is supplied, when necessary, to the probe distal end portion of the therapeutic section or to the jaw, and high-frequency therapeutic treatment, such as coagulation, of the living body tissue is performed.
In the apparatus of the above-described Patent Document 1, when the high-frequency therapeutic treatment is performed, a so-called monopolar type, in which a return electrode plate is disposed on the outside of the patient's body, is used. When the high-frequency therapeutic treatment is performed, a high-frequency current is let to flow from a therapeutic device to the return electrode plate via a living body tissue.
Jpn. Pat. Appln. KOKAI Publication No. 2007-50181 (Patent Document 2) discloses an apparatus in which an ultrasonic therapeutic apparatus is combined with a high-frequency therapeutic device of a so-called bipolar type in which a pair of electrodes for high-frequency therapeutic treatment are assembled. A first electrode section of the pair of electrodes is formed at a probe distal end portion of the treatment section and the other electrode section of the pair of electrodes is provided on the jaw. The jaw is provided with an insulation member which secures a clearance between the second electrode section and the probe distal end portion.
In the apparatus of the structure in which the bipolar-type high-frequency therapeutic device is combined, it is important to secure the clearance between the first electrode section of the probe distal end portion and the second electrode section of the jaw. For example, in a case where there occurs a manufacturing error of each part of the apparatus, an assembly error, etc., a positional displacement occurs between the first electrode section of the probe distal end portion and the second electrode section of the jaw after assembly. In this case, it becomes difficult to keep constant the clearance between the first electrode section of the probe distal end portion and the second electrode section of the jaw. If the clearance between the first electrode section of the probe distal end portion and the second electrode section of the jaw fails to be secured and the first electrode section of the probe distal end portion and the second electrode section of the jaw come in contact, the function for the bipolar high-frequency therapeutic treatment cannot be secured. Thus, since it is necessary to precisely manage a manufacturing error of each part of the apparatus, an assembly error, etc., there arises a problem of an increase in cost, for instance.